Användning av valt namn kopplad till mindre depression hos transungdomar – men bara 74 unga, mätt vid ett tillfälle

Användning av valt namn är kopplad till minskade depressiva symtom, självmordstankar och självmordsbeteende bland transungdomar

Enkäter Psykisk hälsa & suicid

Authors: Stephen T. Russell, Amanda M. Pollitt, Gu Li, Arnold H. Grossman
Journal: Journal of Adolescent Health
Year: 2018
Source: https://doi.org/10.1016/j.jadohealth.2018.02.003

Summary

Researchers used survey answers from 129 trans and gender-nonconforming young people (ages 15 to 21) found through LGBTQ community groups in three US cities. Among the 74 who had picked a new name, those who could use it in more places (home, school, work and with friends) reported less depression and less suicidal thinking and behaviour, even after accounting for social support. The authors concluded that using a chosen name reduces mental health risk. That is plausible, but the study cannot show cause and effect. Everything was measured once, by self-report, in a small community group, and young people with better mental health or more supportive surroundings may simply find it easier to use their chosen name. Hormones and blockers were not measured. The Cass Review's evidence review rated the evidence on social transition, including this study, as low quality.

Key findings

Analysen inkluderade 74 transungdomar (15 till 21 år) som hade ett valt namn, av 129 trans- och könsöverskridande personer i en större studie av HBTQ-ungdomar.
De hittades 2011–2012 via HBTQ-gemenskapsgrupper och högskolegrupper i tre amerikanska städer, och valdes inte för att representera alla transungdomar.
Varje extra miljö där det valda namnet kunde användas hängde samman med en depressionspoäng som var cirka 5 poäng lägre på ett standardiserat frågeformulär.
Varje extra miljö hängde samman med cirka 29 % mindre självmordstankar och cirka 56 % mindre självmordsbeteende, efter hänsyn till bakgrund och övergripande socialt stöd.
I genomsnitt kunde unga använda sitt valda namn i cirka 3 av de 4 miljöerna. Symtomen var lägst bland dem som kunde använda det överallt.
Att använda namnet bara med vänner hängde inte tydligt samman med psykisk hälsa när stödet från nära vänner togs med i beräkningen.
Författarna beskriver sambandet som orsak och verkan (‘minskar risker för psykisk hälsa’), trots att allt mättes vid en enda tidpunkt.

Abstract

PURPOSE: This study aimed to examine the relation between chosen name use, as a proxy for youths' gender affirmation in various contexts, and mental health among transgender youth. METHODS: Data come from a community cohort sample of 129 transgender and gender nonconforming youth from three U.S. cities. We assessed chosen name use across multiple contexts and examined its association with depression, suicidal ideation, and suicidal behavior. RESULTS: After adjusting for personal characteristics and social support, chosen name use in more contexts was associated with lower depression, suicidal ideation, and suicidal behavior. Depression, suicidal ideation, and suicidal behavior were lowest when chosen names could be used in all four contexts. CONCLUSION: For transgender youth who choose a name different from the one given at birth, use of their chosen name in multiple contexts affirms their gender identity and reduces mental health risks known to be high in this group.

Conclusion

For transgender youth who choose a name different from the one given at birth, use of their chosen name in multiple contexts affirms their gender identity and reduces mental health risks known to be high in this group. The authors argue that schools, workplaces, healthcare providers and other institutions should allow chosen names in records and IDs, and that peers, parents and teachers can support transgender youth's mental health by using their chosen names.

Methodological limitations

Measured once: Although the people came from a larger long-term study, this analysis uses data from one point in time. So it cannot show that name use came first, or caused better mental health.
Cause may run the other way: Young people who are less depressed, more confident or in more accepting settings may find it easier to use a chosen name. The direction of the link cannot be told.
Small group: Only 74 young people were analysed, with 5 to 28 people in many subgroups. Some results were unreliable (for example, impossible-looking results for the six Asian young people).
Not a representative group: People were found through LGBTQ community groups and college groups in three cities, so results may not apply to youth referred to clinics or less connected youth.
All self-reported: Depression, suicidal thoughts and acts, support and name use were all reported by the same person in the same survey, which can make links look stronger than they are.
Rough measure of name use: Name use was a count of yes/no answers to whether they could go by their name in four settings, with nothing on how often, how long or by whom. The average was about 3 of 4, leaving little variation.
Other factors not accounted for: The study accounted for overall support but not parents' acceptance specifically, past mental illness, past therapy, bullying or abuse, or hormones and blockers. A commentary in the same journal noted these could explain the link.
Claims go beyond the data: The summary says chosen name use 'reduces' mental health risk, which a one-time survey showing a link cannot prove.
Old and narrow group: Data were collected in 2011–2012, before the sharp rise in gender clinic referrals and the shift toward mostly teenage girls being referred today.
Rated low quality: The Cass Review's evidence review of social transition (Hall and colleagues, 2024) included this study and judged the evidence limited and low quality, mostly one-time surveys of unrepresentative groups.

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Summary

Key findings

Abstract

Conclusion